Heidrich J, Liese A D, Kalic M, Winter-Enbergs A, Wellmann J, Roeder N, Kerber S, Breithardt G, Scheld H H, Kleine-Katthöfer P, Keil U
Institut für Epidemiologie und Sozialmedizin, Universitätsklinikum Münster, Germany.
Dtsch Med Wochenschr. 2002 Mar 29;127(13):667-72. doi: 10.1055/s-2002-23480.
EuroASPIRE (European Action on Secondary Prevention through Intervention to Reduce Events) is a European multicenter study on secondary prevention in patients with coronary heart disease (CHD). The first cross-sectional survey was undertaken in 1995/96 among 3569 patients from nine countries. A second cross-sectional survey (EuroASPIRE II) was conducted in 1999/2000 among 5556 patients from 15 countries to evaluate among others whether coronary prevention had improved since the first.
The present study was conducted in the region of Münster, Germany, as part of the EuroASPIRE study. Consecutive patients, men and women up to 70 years of age with established CHD, were identified retrospectively. A total of 392 (EuroASPIRE I) and 402 (EuroASPIRE II) patients participated. Information on cardiovascular risk factors, lifestyle and medication were obtained through medical records, interviews and examinations.
Both studies demonstrate a high prevalence of risk factors among CHD patients. At the time of the interview more than 60% of the patients in both surveys had two or more risk factors. The comparison of EuroASPIRE I and II reveals a substantial decrease of 20% in the prevalence of hypercholesterolemia, but an increase in the prevalence of hypertension and obesity. ACE-inhibitors, betablockers and lipid lowering drugs, especially statins, were used more frequently in EuroASPIRE II.
We conclude that secondary prevention of CHD in the region of Münster like in the other European study regions is less than optimal and has not substantially improved between 1996 and 2000. Potential reasons are discussed.
欧洲冠心病二级预防干预降低事件行动（EuroASPIRE）是一项针对冠心病（CHD）患者二级预防的欧洲多中心研究。1995/1996年对来自9个国家的3569名患者进行了首次横断面调查。1999/2000年对来自15个国家的5556名患者进行了第二次横断面调查（EuroASPIRE II），以评估自首次调查以来冠心病预防措施是否有所改善等情况。
本研究在德国明斯特地区进行，是EuroASPIRE研究的一部分。对年龄在70岁及以下已确诊冠心病的连续患者进行回顾性识别。共有392名（EuroASPIRE I）和402名（EuroASPIRE II）患者参与。通过病历、访谈和检查获取有关心血管危险因素、生活方式和用药的信息。
两项研究均表明冠心病患者中危险因素的患病率很高。在访谈时，两项调查中均有超过60%的患者有两种或更多危险因素。EuroASPIRE I和II的比较显示，高胆固醇血症的患病率大幅下降了20%，但高血压和肥胖的患病率有所上升。在EuroASPIRE II中，血管紧张素转换酶抑制剂、β受体阻滞剂和降脂药物，尤其是他汀类药物的使用更为频繁。
我们得出结论，与其他欧洲研究地区一样，明斯特地区冠心病的二级预防并不理想，在1996年至2000年期间也没有实质性改善。文中讨论了潜在原因。
